Pre-school Booster (4-in-1 DtaP/IPV)

The impact of vaccination

The table below shows the average number of deaths in the UK each year, before and after introduction of a vaccine:

Disease

Before

After

Diphtheria

4000

0

Tetanus

200

0

Pertussis

1500

3

Polio

700

0

TOTAL

6400

3

Source: Public Health England

Key vaccine facts

This vaccine boosts protection against these four serious diseases: diphtheria, tetanus, whooping cough (pertussis), and polio. Before vaccines existed, these diseases used to kill thousands of children in the UK every year, as the table above shows.

In the UK it is given at around 3 years and 4 months to children who received the initial doses of the vaccines in the first year of life (see the 5-in-1 vaccine for children born on or before 31st July 2017, and the 6-in-1 vaccine for children born on or after 1st August 2017).

It can safely be given at the same time as other vaccines in the schedule (see the full UK routine schedule for details of the other vaccines). It is a combination vaccine, which reduces the number of injections a child needs. See more about combination vaccines and multiple vaccinations and why these are not a risk to your child's immune system.

The Pre-school Booster vaccine used in the UK does not contain any live bacteria or viruses. It cannot cause any of the diseases it protects against.

Two brands of Pre-school Booster vaccine are used in the UK: Repevax (see the Patient Information Leaflet ) and Infanrix IPV (see the Patient Information Leaflet ). A third vaccine, Boostrix-IPV, is only used for pertussis vaccination in pregnancy. During the transition from the 5-in-1 vaccine to the 6-in-1 vaccine (late September 2017 onwards) it is possible that 5-in-1 vaccines may also occasionally be used for pre-school boosting. The 5-in-1 vaccine is very similar to the Pre-School Booster, but protects against Hib disease as well as against diphtheria, tetanus, whooping cough (pertussis) and polio. See the page on the 5-in-1 vaccine for more information.

Ingredients

The Pre-school Booster vaccines used in the UK for children are called Repevax and Infanrix IPV.

Apart from the active ingredients (the antigens), these vaccines both contain a small amount of aluminium, which strengthens and lengthens the immune response to the vaccine. See more information on aluminium in vaccines.

The vaccines also contain small amounts of:

Polysorbate, used as an emulsifier to hold other ingredients together (Repevax only)

In addition, Repevax may contain traces of neomycin, streptomycin and polymyxin B, which are all antibiotics used in the production process. See more information on antibiotics in vaccines. It may also contain tiny traces of formaldehyde or glutaraldehyde, used during the manufacturing process to inactivate the viruses in the vaccine.

The Pre-school Booster vaccines used in the UK do not contain the preservative thiomersal (mercury).

Side effects

The following reactions are common but not serious:

redness, tenderness and/or swelling at the injection site

slightly raised temperature

irritability

sickness

diarrhoea

loss of appetite

Many of these symptoms can be relieved by giving paracetamol (Calpol)if your child is over 2 months, or ibuprofen if your child is over 3 months and weighs more than 5kg (see NHS Choices for more advice on giving painkillers to babies and children).

More serious side effects are very rare:

high temperatures, sometimes leading to fits (also called convulsions or febrile seizures)

unusual high-pitched screaming and hypotonic-hyporesponsive episodes (HHE), during which the child may become blue, pale and/or limp

You should consult your doctor if these reactions happen after vaccination. This is mainly to check that it is the vaccine causing the symptoms, and not some unrelated disease. Symptoms such as fits can be very worrying for parents, but there is no evidence of long-term effects. Children can normally safely receive vaccines in the future.

As with any vaccine, medicine or food, there is a very small chance of a severe allergic reaction (anaphylaxis). Anaphylaxis is different from less severe allergic reactions because it causes life-threatening breathing and/or circulation problems. It is always serious but can be treated with adrenaline. In the UK between 1997 and 2003 there were a total of 130 reports of anaphylaxis following ALL immunisations, but all of these people survived. Around 117 million doses of vaccines were given in the UK during this period, making the overall rate around 1 in 900,000. Depending on the cause of the reaction, and following expert guidance, the person may be able to have vaccinations in the future.

Reactions listed under ‘possible side effects’ or ‘adverse events’ on vaccine product information sheets may not all be directly linked to the vaccine. See Vaccine side effects and adverse reactions for more information on why this is the case.

More information about the vaccine

The full name of the Pre-School Booster vaccine is DTaP/IPV, which stands for ‘Diphtheria, Tetanus, acellular Pertussis and Inactivated Polio Vaccine’.

The vaccine includes the acellular pertussis vaccine (the ‘aP’ in ‘DTaP’). This uses only those parts of the pertussis (whooping cough) bacteria needed to produce an immune response. This greatly reduces the chance of serious side effects such as high temperatures, screaming episodes, and HHE (see side effects above). The whole cell (wP) vaccine used in the UK until 2004 contained many more antigens and had a greater risk of side effects.

The vaccine also includes inactivated polio virus (IPV). As this is inactivated, it cannot cause polio (which was a very small risk with the live, oral polio vaccine used in the UK until 2004).

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Published by Sarah Loving. Medical content reviewed by Professor Andrew Pollard.Please click here to contact us if you have comments about the Vaccine Knowledge website. We can’t answer all the individual queries we get, but we will use your suggestions and questions to improve the website. You should consult your doctor or other healthcare provider if you need specific advice on vaccines for you or your child.